Gaudette Logan W, Ackerman Kathryn E, Bouxsein Mary L, Bruneau Michelle M, de Souza Junior José Roberto, Garrahan Margaret, Gehman Sarah, Hughes Julie M, Outerleys Jereme, Willy Richard W, Davis Irene S, Popp Kristin L, Tenforde Adam S
Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Cambridge, Massachusetts, USA.
Endocrine Unit, Mass General Hospital, Boston, Massachusetts, USA.
BMJ Open Sport Exerc Med. 2025 Jun 30;11(2):e002469. doi: 10.1136/bmjsem-2025-002469. eCollection 2025.
Bone stress injury (BSI) is a common overuse injury in female athletes that can occur in a variety of bones, including both proximal (pelvis, sacrum, femoral neck) or distal (tibia, fibula, metatarsals) locations. Prior work has demonstrated differences in running biomechanics in those with BSI; however, this was not separated by anatomy. We hypothesised that both female athletes with distal BSI and female athletes with proximal BSI would have lower cadence, higher centre of mass (COM) and lower duty factor than those without prior BSI.
Cross-sectional study of 45 female athletes (15 with prior distal BSI, 15 with prior proximal BSI and 15 with no BSI history). Each ran on an instrumented treadmill at self-selected and 5-kilometre race speeds, with data collected in a fresh and exerted state. A series of analysis of variance tests (ANOVAs, group by condition) were used to analyse the results.
Participants with previous proximal BSI ran with greater vertical COM excursion compared with those with no previous BSI at race speed (10.2±1.7 cm vs 8.5±0.8 cm (p<0.001)). The proximal BSI population had a lower cadence than the no prior BSI population at race speed (170±13 steps per minute vs 180±10 steps per minute (p=0.012)). Duty factor was lower in the proximal BSI group compared with the distal BSI group at the race speed (32±3% vs 34±3% (p=0.013)).
COM and cadence should be further investigated for association with proximal BSI.
骨应力损伤（BSI）是女性运动员常见的过度使用损伤，可发生于多种骨骼，包括近端（骨盆、骶骨、股骨颈）或远端（胫骨、腓骨、跖骨）部位。先前的研究已证明患有BSI的运动员在跑步生物力学方面存在差异；然而，这并未按解剖部位进行区分。我们假设，与无BSI病史的女性运动员相比，患有远端BSI的女性运动员和患有近端BSI的女性运动员均会有更低的步频、更高的重心（COM）和更低的负荷率。
对45名女性运动员进行横断面研究（15名有远端BSI病史、15名有近端BSI病史和15名无BSI病史）。每位运动员在装有仪器的跑步机上以自我选择的速度和5公里赛跑速度跑步，在状态良好和疲劳状态下收集数据。使用一系列方差分析测试（ANOVA，按条件分组）分析结果。
与无BSI病史的运动员相比，有近端BSI病史的参与者在赛跑速度下的垂直COM偏移更大（10.2±1.7厘米对8.5±0.8厘米（p<0.001））。在赛跑速度下，近端BSI人群的步频低于无BSI病史人群（每分钟170±13步对180±10步（p=0.012））。在赛跑速度下，近端BSI组的负荷率低于远端BSI组（32±3%对34±3%（p=0.013））。
应进一步研究COM和步频与近端BSI的关联。
